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CMS Notifies Individuals About Potential Data Breach

Posted Sep 9, 20243 min Read

Regulatory & Clinical
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The Centers for Medicare & Medicaid Services (CMS) today issued a press release indicating that it and Wisconsin Physicians Service Insurance Corporation (WPS) are notifying people whose protected health information or other personally identifiable information may have been compromised in connection with Medicare administrative services provided by WPS. WPS processes Medicare Part A and Part B claims in various locations around the country.

CMS believes a data vulnerability issue in software used by WPS has been resolved. However, between May 27 through 31, 2023, it was possible for unauthorized third parties to gain access to personal information. WPS has confirmed that an unauthorized user copied some beneficiary information.

It does not appear that provider claims processing or other operational activities with WPS are currently impacted. Beneficiaries can continue to use their Medicare cards and providers can still use current Medicare numbers for claims submissions. However, if a beneficiary’s Medicare number was potentially affected, a new Medicare card with a new number will be issued.

SNF providers that submit claims with WPS should do the following: 

  • Continue to use the beneficiary’s current Medicare number for claims.
  • Be prepared to answer resident/family member questions about this issue by providing a copy of the CMS press release.
  • If they have further questions regarding this incident, recommend they call the Experian dedicated and confidential toll-free response line at 833-931-5700.
  • If a resident/family member informs you they have been impacted and will be receiving a new Medicare card, please ask them to provide a copy prior to the next Medicare claim submission.

AHCA/NCAL will monitor the situation closely and provide updates as necessary.

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